Ependymomas are brain tumors that arise from  Ependymoma (Grade II): The most common, this type is

ependymal cells. The most common surgical treatment typically benign and found along the ventricles in either

for ependymoma is craniotomy and surgical removal, the infratentorial region or the spine. This type is

and the most common nonsurgical treatment is further categorized—on the basis of how the cells look

stereotactic radiosurgery. under a microscope—as papillary ependymoma, clear

cell ependymoma or tanycytic ependymoma.
Ependymomas, a type of glioma, are uncommon,  RELA fusion–positive (Grade II or III): This is a new
accounting for 1.9 percent of primary brain tumors designation, added in 2016. This type is characterized
among adults and 9 percent among children. by a molecular abnormality, RELA, that promotes tumor
Ependymomas can arise in the brain or spine. For formation and growth. This tumor type is found in the
information about spinal ependymomas, please click supratentorial region.
here.  Anaplastic ependymoma (Grade III): These are the
fastest growing ependymomas and are malignant. They
When these tumors occur in the brain, they are typically
tend to occur in the infratentorial region.
described as arising in either
the supratentorial or infratentorial region of the brain.
Subependymomas and myxopapillary ependymomas,
The terms supratentorial and infratentorial describe
the Grade I tumors, are easier to treat than the Grade II
each region in relation to the tentorium.
and Grade III tumors, which tend to recur after initial
treatment. However, in general, ependymal tumors tend
 The supratentorial region makes up the upper two-
to not invade nearby tissue but instead displace it as
thirds of the brain. It includes the cerebrum and the
they grow, making surgical removal of many of these
lateral and third ventricles.
tumors possible.
 The infratentorial region makes up the lower third of
the brain. It includes the brainstem, cerebellum and About 10 to 15 percent of ependymomas metastasize,
fourth ventricle. via the cerebrospinal fluid, to other areas in the central
nervous system. It is rare for an ependymoma to
Ependymomas are assigned a grade that reflects the
metastasize outside the central nervous system.
appearance of the tumor cells under a microscope.
Grade I designates a typical tumor cell appearance,
Grade II a slightly atypical tumor cell appearance and
Grade III a significantly atypical tumor cell appearance.

Ependymomas are broken down into the following

major types:

 Subependymoma (Grade I): This type is slow-growing

and benign; it arises near a ventricle.
 Myxopapillary ependymoma (Grade I): This type is
usually slow-growing and benign; it is found in the
spine.